GP productivity is the tops, but ageing workforce is a concern

With more than a third of GPs aged over 55, calls are growing for greater investment in general practice to encourage more into the speciality

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GPs are providing high-quality, cost-effective care for their patients, according the Productivity Commission’s Report on Government Services released last week.

However, with more than a third of GPs aged over 55, calls are growing for greater government investment in general practice to encourage more recruitment into the speciality.

“GPs are working harder but are feeling the squeeze from underinvestment in Medicare rebates for patients and general practice across the board,” AMA President, Dr Tony Bartone, said.

“Government spending on GP services is currently about 8% of total government spending on health. The AMA is calling for this to be lifted over time to about 10% of total government health spending.

“This will lead to long-term savings to the health system, and improved health outcomes by keeping patients out of hospital,” Dr Bartone said.

“The report shows that there were about 2.9 million presentations to public hospital emergency departments that could have been handled by GPs.”

The report said that 2017-18, almost 37,000 GPs provided around 160.3 million Medicare services to patients around Australia.

It also found an extremely high satisfaction rate with GP services, with more than 90% of patients reporting that their GP listened closely to them, showed them respect, and spent enough time with them.

“These figures have increased steadily over the previous five years, demonstrating that GPs are responding to the growing demand in the community, with an ageing population and rising rates of chronic diseases and complex conditions,” Dr Bartone said.

In a prebudget submission to the government last week, the AMA called for the introduction of quarterly “care coordination” payments for GPs to support proactive, team-based care of at-risk chronic disease patients.

It also asked for more funding for GP practice incentive programs (PIP), the adoption of an “extended Level B” item to encourage longer consults, and GP-specific telehealth item numbers.

The submissions also called for:

• Retaining the Aged Care Access Incentive (ACAI), scheduled for abolition from 1 May 2019;
• Adopting an “extended” Level B MBS consultation item that recognises the extra work involved for GPs who spend more time with their patients;
• Changing the Medicare definition of after-hours in-rooms consultation items to start at 6pm on weeknights and noon on Saturdays;
• Introducing specific MBS rebates for GP telehealth consultations provided by a patient’s usual GP for: after-hours services, patients with a GP Management Plan, patients with mobility problems, and patients in residential aged care facilities;
• Funding dressings for patients who have a diabetic foot ulcer or leg ulcer; or a venous or arterial leg ulcer; or are 65 years of age and over;
• Supporting GP-led team-based care by lifting caps on subsidies under the incoming Workforce Incentive Program for the employment of nurses, pharmacists, and allied health professionals in general practice.